Emotional as well as cognitive brain functions are involved. We do not feel as overwhelmed by our emotions and as if we have no control over the situation. The ADHD sufferer often feels overwhelmed by an emotion he is caught up in, so much so that his powers of judgement and decision-making functions are crowded out.
When we are aware of our own involvement in a situation – in other words, when we are self-aware – we are able to think about it properly. Once we have that awareness, we can evaluate our own behaviour and make the right choices. In this way alone lies positive change. Emotions are not the opposite of a state of awareness, but are in fact an important searchlight to highlight what questions we should ask to bring about insight and growth.
I believe awareness to be essential not only for those with ADHD in managing their symptoms, but for every one of us as we grow as human beings. We will discuss this further in the chapter on neurotherapy. Neurotherapy generally improves self-awareness.
Back to the initial interview: You need to start at a specific point when describing the problem as you experience it, to the therapist. Some people’s thought process is more analytical whereas others think in a more systemic way. Some mothers arrive with a list of ten points, with pregnancy as point one. Others start with an incident that occurred the day before the interview and others sum up the problem in a single sentence.
It disturbs me greatly that many test conductors allocate only a ten-minute time slot for the first interview. Time is a factor, but I do not understand how one can get to the essence of the problem after just a few questions. You may perhaps leave a consultation clutching a prescription, but plagued with doubts, questions and fears.
Once the parent has responded to my initial statement – “tell me, I’m listening”, I ask questions about those aspects that may be relevant and which the parent has not yet addressed. It is primarily in response to the first question that I start to discern synchronicities and patterns hidden behind the general symptoms that I would not necessarily have noticed at first. A large percentage of children with ADHD, for example, had high fevers or fever convulsions at a very young age. Most are also emotionally very sensitive, though it often seems that they are not at all aware of other people’s needs. They are also often creative thinkers. In adults in particular, it is clear that people with ADHD do not like problems. They appear to need their environment to be under control because of the often chaotic state of their own thoughts.
The following questions are useful not only in setting up an intervention programme but also in other practical aspects of managing the condition. They may perhaps make you as a mother smile as you realise that there are many other moms walking the same path as yours. As already mentioned, I have also included general answers and comments and indicated where there is no clear pattern. Questions that are more appropriate in an initial interview with adult ADHD sufferers are covered later in this book.
Please bear in mind that the answers are based on my experience as a therapist and not on a research project.
Questions that could shed light
Was the birth normal?
There is no clearly observable pattern here. Some ADHD children were born naturally while others were delivered by Caesarean section, without complications. Where there have been forceps deliveries and other complications I ask for more details and examine available clinical reports.
Were there any complications or traumas from shortly after birth until the child was two years of age?
There was often an incident of a very high fever.
Was your child a calm or restless baby?
Many ADHD children were difficult babies who seldom slept through the night.
Did your child reach the developmental milestones within the normal time frame?
“Yes. She actually started walking early. Though she did start talking a little late. Her speech has always been a bit unclear. You still can’t always get what she’s saying if you don’t know her.”
Was your child very demanding from a young age (about three or four) or did she sometimes play alone?
Surprisingly many parents say that their children were able to play alone for hours on end at preschool age. (According to the literature, the symptoms usually start presenting at this age.) Some children, on the other hand, were very active and demanding from the time they started walking.
When did you receive the first negative feedback from school?
The “problems” usually begin in Grade R. The urgency of the teacher’s concern usually increases during the second half of the year. (If negative feedback only starts in Grade 2 or later, a learning problem may be the core issue.)
What was the main focus of the complaints?
“He doesn’t concentrate when we do mat work.”
“She doesn’t complete her work.”
“He disturbs his friends.”
“He won’t stop talking in class.”
“He doesn’t wait his turn.”
“His drawing/handwriting is untidy.”
“She keeps losing things.”
“He forgets to bring messages home or to write down his homework.”
“He has difficulty with reading.”
(The responses vary markedly depending on the child’s age. I will discuss the behaviour that is typically associated with ADHD at greater length later. The above are merely a few examples of very common complaints.)
Do you have difficulties with discipline?
In more structured households there are fewer discipline problems. A general complaint is that it often seems as if the child does not hear what is being said. Behaviour that is regarded as being naughty or disobedient is common.
If you give your child two or three tasks to perform, can she remember them and carry them out?
“Oh, no. On the way to do the first she becomes distracted – and when I look for her ten minutes later she’s playing with the dog.”
Does he get up on time in the mornings and is he ready for school on time?
“Every morning is a battle. He’d take hours just to put his socks on if I didn’t hurry him along or threaten him. And it’s the same with brushing his teeth, eating breakfast and absolutely everything he has to do. We’re late every morning.”
Does she do her homework regularly and properly?
“Homework is the worst time of day in our home. It takes an eternity to get going and then ends in tears. And everything is always lost or in a mess.”
What are test results generally like?
“Abysmal. Sometimes I am absolutely sure that he knows his work. But when the marks come back it’s a disaster.”
“Sometimes the marks are excellent and sometimes they’re very bad.”
Can she sit and do her homework alone?
“Not at all. As soon as I turn my back she’s gone. Sometimes if I threaten blue murder she’ll remain seated at the table. But when I return half an hour later she’s done nothing.”
What has your intuitive sense of your child’s intellectual ability been from infancy?
“That’s just what I can’t understand. Everyone’s always remarked how quick and bright she is. It was such a shock when we saw her first school report.”
Does your child talk a lot?
“Sometimes without stopping. He also says the most inappropriate things sometimes. We’ll be chatting about current events and he’ll interrupt someone with a statement about something